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NPI Code Detail

MEDICARE: SHANTELL BONEE' MANLEY PHARMD

MEDICARE: SHANTELL BONEE' MANLEY PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist0202211577VA

General Provider Information

NPI Number : 1477806610
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANTELL BONEE' MANLEY PHARMD
Provider Business Mailing Address
First Line : 13007 WARWICK BLVD
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23602-8315
Country : US
Telephone Number : 757-882-1074
Fax Number :
Provider Business Practice Location Address
First Line : 13007 WARWICK BLVD
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23602-8315
Country : US
Telephone Number : 757-882-1074
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2012
Last Update Date : 10/25/2012

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Directions to “ SHANTELL BONEE' MANLEY PHARMD” Practice Location

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